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The novel's French translation, Pauvres petits chagrins, was selected for the 2019 edition of Quebec's Le Combat des livres, where it was defended by writer Deni Ellis Béchard.

In a note at the start of Women Talking (2018), Toews describes the novel as "a reaction through fiction" to the true-life events that took place between 2005 and 2009 on the Manitoba Colony, a remote Mennonite community in Bolivia. Girls and women would regularly wake up in the mornings to discover they had been sexually violated. The attacks were dismissed as 'wild female imagination,' or else attributed to ghosts or demons. Eventually it was revealed that a group of colony men had been spraying an animal anesthetic into neighboring houses at night, rendering everyone unconscious, and raping all the women (infant, elderly and relatives included). The colony elders, deciding that the case was too difficult to handle themselves, called local police to take the perpetrators into custody.

The novel was a shortlisted finalist for the Governor General's Award for English-language fiction at the 2018 Governor General's Awards.

All My Puny Sorrows (2014) recounts the tumultuous relationship of the Von Riesen sisters, Elfrieda and Yolandi, the only children of an intellectual, free-spirited family from a conservative Mennonite community. Yolandi, the novel's narrator, has always lived in her sister's shadow. Whereas Elfrieda is a gifted, beautiful, happily married, and much celebrated concert pianist, Yolandi feels like a failure, with a floundering writing career and teenage children from separate fathers. Yet it is Elfrieda who suffers from acute depression and a desire to die, much like her father before her, who killed himself by stepping in front of a train. When Elfrieda makes a second suicide attempt on the eve of an international concert tour, Yolandi makes it her mission to save her sister, even as Elf begs her to accompany her to a Swiss clinic and enable her death. Yolandi writes: "She wanted to die and I wanted her to live and we were enemies who loved each other."

All My Puny Sorrows received starred reviews in Library Journal, Kirkus Reviews, and Publishers Weekly and was a Reference and Users Services Association Notable Book. It also appeared on a number of year-end best-book lists, including The Globe and Mail, The Boston Globe, The Washington Post, The New Republic, and The Daily Telegraph. The novel won the 2014 Rogers Writers' Trust Fiction Prize. The jury described it as "a haunting novel of tremendous feeling, beautifully written and profoundly humane... Miriam Toews, a dazzling literary alchemist who manages to summon all the joyous and heart-breaking humanity of her characters, has produced a work of astonishing depth. Reading it is an unforgettable experience." The novel was also awarded Italy's 2015 Sinbad Prize for Foreign Fiction.

All My Puny Sorrows was shortlisted for the 2014 Scotiabank Giller Prize, the 2015 Folio Prize for Literature, and the 2015 Wellcome Book Prize. It was longlisted for the 2015 Andrew Carnegie Medal for Excellence in Fiction and the 2016 International Dublin Literary Award.

With her fifth novel, Irma Voth (2011), Toews returned to Mennonite settings, re-examining the ways in which communities can limit personal freedom, and how belonging can turn to estrangement when old and new value systems clash. The novel opens in an old order Mennonite settlement in Mexico's Chihuahuan Desert. Nineteen-year-old Irma Voth has been banished to a neighbouring farm by her strict, religious father after secretly marrying a non-Mennonite Mexican. Her new husband disappears into the drug trade and Irma is left alone to tend to the farm. Her world is transformed when a filmmaker from Mexico City arrives to make a film about Mennonites. Irma is hired as a translator for the film's female protagonist, and her involvement with the wildly creative film crew brings her into dangerous conflict with her father, while at the same time helping her better understand her place in the world. When her father's violence escalates and the tragedy that has haunted her family begins to surface, Irma receives the blessing of her mother to flee the encampment, and to take her two younger sisters with her, one of whom is an infant. They eventually settle in Mexico City, where the two older sisters must embrace the ways of the city in order to survive and raise their infant sister.

Toews has said that the novel draws heavily on events leading up to the 2010 suicide of her only sibling Marjorie.

The Flying Troutmans (2008) is a road-trip novel narrated by 28-year-old Hattie, who takes charge of her teenage niece and nephew after her sister Min is admitted to a psychiatric ward. Overwhelmed by the responsibility, Hattie enacts an ill-conceived plan to find the kids' long-lost father in California.

The novel was awarded the 2008 Rogers Writers' Trust Fiction Prize. The prize jury called the novel "a love song to young people trying to navigate the volcanic world of adult emotions." The novel was also longlisted for the Orange Prize for Fiction, and named a Globe and Mail Best Book.

Toews had a leading role in the feature film Silent Light, written and directed by Mexican filmmaker Carlos Reygadas, and winner of the 2007 Cannes Jury Prize, an experience that informed her fifth novel, Irma Voth (2011).

Toews has said that Irma Voth was inspired in part by her experience in playing a lead role in Silent Light, the 2007 film written and directed by Mexican filmmaker Carlos Reygadas. Reygadas invited Toews to do a screen test for the role of Esther, a conservative Mennonite wife, on the basis of reading her third novel, A Complicated Kindness, and seeing her author photo on the back flap of the book. The film was shot in Plautdietsch, a language neither the director nor Toews fully understood. Toews worked with her mother, a native speaker of Plautdietsch, to deliver her lines phonetically. The film won a number of international awards, including the Jury Prize at the Cannes Film Festival. Toews was nominated for best actress at Mexico's Ariel Awards for her performance, one of nine nominations for the film.

Toews' third novel, A Complicated Kindness (2004), is set in East Village, a small religious Mennonite town much like her native Steinbach. The narrator is Nomi Nickel, a curious, defiant, sardonic sixteen-year-old who dreams of hanging out with Lou Reed in the 'real' East Village of New York City. She lives alone with her doleful father, after the departure of her older sister and the unexplained disappearance of her mother. Unlike her father, who is a dutiful member of the town church, Nomi is rebellious by nature, and her compulsive questioning brings her into conflict with the town's various authorities, most notably Hans Rosenfeldt, the sanctimonious church pastor.

A Complicated Kindness was highly acclaimed nationally and internationally, with the character of Nomi Nickel invoking comparisons to J. D. Salinger's Holden Caulfield. It won the 2004 Governor General's Award for Fiction, described by the jury as "an unforgettable coming-of-age story... melancholic and hopeful, as beautifully complicated as life itself." It was also shortlisted for the Scotiabank Giller Prize and longlisted for the International Dublin Literary Award. It spent over a year on the Canadian bestseller lists and went on to be selected for the 2006 edition of Canada Reads, the first book by a female writer to win the competition.

Toews has written for CBC's WireTap, Canadian Geographic, Geist, The Guardian, The New York Times Magazine, Intelligent Life, and Saturday Night. In 1999, she won a National Magazine Award Gold Medal for Humour. She is the author of The X Letters, a series of personal dispatches addressed to the father of her son, which were featured on This American Life in an episode about missing parents.

Toews' father died by suicide in 1998. His death inspired Toews to write a memoir in her father's voice, Swing Low: A Life. The book was greeted as an instant classic in the modern literature on mental illness, and it won the Alexander Kennedy Isbister Award for Non-Fiction and the McNally Robinson Book of the Year Award. Toews' father suffered from bipolar disorder much of his life, but he was an active and well-respected elementary school teacher who lobbied to establish Steinbach's first public library. After his death, the Steinbach Library Board opened the Melvin C. Toews Reading Garden on the grounds of the library he worked to create. Toews' older sister and only sibling, Marjorie, died by suicide in 2010, almost 12 years to the day after their father.

Toews wrote her first novel, Summer of My Amazing Luck (1996), published by Turnstone Press, while working as a freelance journalist. The novel, which explores the evolving friendship of two single mothers in a Winnipeg public housing complex, developed from a documentary which Toews was preparing for CBC Radio on the subject of welfare mothers. It was shortlisted for the Stephen Leacock Memorial Medal for Humour, and the McNally Robinson Book of the Year Award. Toews won the latter prize with her second novel, A Boy of Good Breeding (1998).

Miriam Toews (/ˈ t eɪ v z / ; born 1964) OM is a Canadian writer, best known for her novels A Complicated Kindness (2004) and All My Puny Sorrows (2014). She has won a number of literary prizes including the Governor General's Award for Fiction and the Writers' Trust Engel/Findley Award for body of work. She is also a two-time finalist for the Scotiabank Giller Prize and a two-time winner of the Rogers Writers' Trust Fiction Prize.

Toews grew up in Steinbach, Manitoba, the second daughter of Mennonite parents, both part of the Kleine Gemeinde. Through her father, Melvin C. Toews, she is a direct descendant of one of Steinbach's first settlers, Klaas R. Reimer (1837–1906), who arrived in Manitoba in 1874 from Ukraine. Her mother, Elvira Loewen, is a daughter of the late C. T. Loewen, a respected entrepreneur who founded a lumber business that would become Loewen Windows. As a teenager, Toews rode horses and took part in provincial dressage and barrel-racing competitions and attended high school at the Steinbach Regional Secondary School. She left Steinbach at eighteen, living in Montreal and London before settling in Winnipeg. She has a B.A. in Film Studies from the University of Manitoba, and a Bachelor of Journalism degree from the University of King's College, Halifax.